Provider Demographics
NPI:1679243794
Name:MASTON, NIKA
Entity Type:Individual
Prefix:
First Name:NIKA
Middle Name:
Last Name:MASTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 KENSINGTON DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-3913
Mailing Address - Country:US
Mailing Address - Phone:937-701-9036
Mailing Address - Fax:
Practice Address - Street 1:1701 KENSINGTON DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-3913
Practice Address - Country:US
Practice Address - Phone:937-701-9036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker